COMPLICATIONS AFTER TREATMENT WITH EXTERNAL-BEAM IRRADIATION IN EARLY-STAGE PROSTATE-CANCER PATIENTS - A PROSPECTIVE MULTIINSTITUTIONAL OUTCOMES STUDY

Purpose: To use data from a prospective quality-of-life study to asses s differences in disease-specific and general health-related quality-o f-life changes after treatment with different external-beam irradiatio n techniques for prostate cancer, Patients and Methods: Patients were divided into three groups based on their pretreatment field size and p lanning technique: whole pelvis, small field, or conformal. Measures o f bowel, urinary, and sexual function and of global health-related qua lity-of-life parameters (from the Health Survey Short Form [SF-36] and the Profile of Mood Stares [POMS]) were obtained from self-report que stionnaires completed before initiation of therapy and at 3 and 12 mon ths after therapy, Results: Irritative gastrointestinal and genitourin ary side effects were frequent 3 months after treatment, but were subs tantially improved at 12 months. Sexual dysfunction increased steadily over the study period. The POMS and the SF-36 did not demonstrate sig nificant changes over time. Despite small patient numbers, we found tr ends in favor of conformal therapy across several symptom measures, in cluding sexual function, In the fatigue, energy, and vigor subscales, patients who received whole-pelvis treatment fared significantly worse than those in the other two groups, Conclusion: Prospective, detailed data from a feasibility study allowed us to assess the effect of tech nique on quality of life following external-beam irradiation. Although limited by the small planned sample size, these results suggest that smaller radiation fields limit treatment-related complications, includ ing, unexpectedly, sexual dysfunction. However, confirmation in a larg er study is necessary. (C) 1997 by American Society of Clinical Oncolo gy.